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¹S.B. Ankara Numune Eğitim ve Araştırma Hast., 1. Göz Kliniği, Ankara, Uz. Dr.
²S.B. Ankara Numune Eğitim ve Araştırma Hast., 1. Göz Kliniği, Ankara, Doç. Dr.
³Gazi Üniversitesi Tıp Fakültesi, Patoloji A.D., Ankara, Doç. Dr.
⁴S.B. Ankara Numune Eğitim ve Araştırma Hast., 1. Göz Kliniği Şefi, Ankara, Uzm. Purpose: To investigate the histopathological effects of trypan blue staining of the lens capsule before phacoemulsification to facilitate capsulorhexis in cataractous eyes with and without pseudoexfoliation (PEX).
Materials and Methods: In two groups of cataract patients one of which consisted of 20 cases with PEX and the other including 20 cases without PEX, two subgroups were formed with 10 patients in which trypan blue (TB) staining was performed before capsulorhexis and with remaining 10 patients unstained. Therefore, four groups were established as follows: Group 1 (PEX-, TB-), Group 2 (PEX+, TB-), Group 3 (PEX-, TB+), and Group 4 (PEX+, TB+). Capsule specimens were examined histopathologically with light microscope using Hematoxylin-Eosine, Trichrome, and Periodic Acid Schiff dyes, in addition to an immunohistochemical staining with Collagen 4.
Results: Damage in the collagen structure was not detected in any group. No change in epithelial cell histology was found in Group1, however, epithelial degeneration was revealed in 3 eyes in Group 2, in 5 eyes in Group 3, and in 7 eyes in Group 4. (p=0.006). Epithelial degeneration grades were mild in Groups 2 and 3, while in the group with PEX and TB staining (Group 4), the grades of damage were mild in 3 specimens (30%), moderate in 2 specimens (20%), and severe in 3 (30%). Overall, there was a statistically significant relation between capsule staining and epithelial degeneration (p=0.009).
Conclusion: TB capsule staining results in epithelial degeneration in normal eyes, and worsens the degree of the existing degeneration in eyes with PEX. Keywords : Phacoemulsification, capsulorhexis, pseudoexfoliation syndrome, lens capsule, trypan blue